Transcript MRSA and VRE

MRSA and VRE in a Rural
Community Hospital
Graduation Project 2008
Mehvish Ally
What is MRSA?


MRSA (Methicillin-resistant
Staphylococcus aureus ) is a
type of staph infection that is
responsible for human
infections that are very
difficult to treat.
MRSA was discovered in
1961 in the UK. It is now
found worldwide. MRSA is
often referred to in the press
as a "super bug."1
1. multi-resistant
An image of MRSA from
an electron microscope
Purpose

To ascertain whether or not there is a
major difference in infection rates of MRSA
and VRE among rural and urban hospitals
and communities. The rural and urban
areas used for comparison were Bradford
and Pittsburgh, respectively.
What is VRE?

Vancomycin-resistant
Enterococci (VRE) are
bacteria that have
evolved from MRSA
and have become
resistant to the
antibiotic vancomycin.
VRE was not reported
in US hospitals until
1989
An image of VRE from an
electron microscope
Types of MRSA
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
HA-MRSA: Hospital Acquired MRSA
CA-MRSA: Community Acquired MRSA
Symptoms/Affects

Staph infections, including MRSA and VRE,
generally start as small red bumps that
resemble pimples, boils or spider bites.
These can quickly turn into deep, painful
abscesses that require surgical draining.

Sometimes the bacteria remain confined
to the skin. But they can also burrow deep
into the body, causing potentially lifethreatening infections in bones, joints,
surgical wounds, the bloodstream, heart
valves and lungs.
Causes



Unnecessary antibiotic use in humans.
Antibiotics in food and water.
Germ mutation.
Risk Factors

A current or recent hospitalization.
-1.2 million hospital patients are infected with
MRSA each year in the United States.

Residing in a long-term care facility.
-more prevalent

Invasive devices.
-dialysis
-catheterization
-feeding tubes

Recent antibiotic use.
-body becomes immune to antibiotic
Screening and diagnosis

Doctors diagnose MRSA by checking a
tissue sample or nasal secretions for signs
of drug-resistant bacteria.
Treatment


Both hospital and community associated
strains of MRSA still respond to certain
medications.
In hospitals and care facilities, doctors
generally rely on the antibiotic vancomycin
to treat resistant germs.


CA-MRSA may be treated with vancomycin
or other antibiotics that have proved
effective against particular strains, but
overuse of vancomycin has led to VRE
outbreaks.
To help reduce the threat of VRE, doctors
may drain an abscess caused by MRSA
rather than treat the infection with drugs.
Prevention
HA-MRSA


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Ask all hospital staff to
wash their hands or use
an alcohol-based hand
sanitizer before touching
you — every time.
Wash your own hands
frequently.
Make sure that
intravenous tubes and
catheters are inserted
under sterile conditions,
CA-MRSA
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

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Wash your hands.
Keep personal items
personal.
Keep wounds covered
Shower after athletic
games or practices.
Sanitize linens.
Use antibiotics
appropriately.
The impacts

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Mortality rate for patient without MRSA in
2004: 2.1%
Mortality rate for patient with MRSA in
2004: 8.9%
were four times as likely to die
Had hospital stays more than two and a
half times longer



In 2004, the average charge for a
hospitalization without MRSA : $28, 711
Average charge for a hospitalization with
MRSA: $87,900
Hospital charges were three times as
much
Recent developments

http://www.cnn.com/2008/HEALTH/conditi
ons/03/12/cat.staph.ap/index.html?iref=n
ewssearch
Results
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MRSA constituted 50% of all staph
infections in Bradford and Pittsburgh.
VRE – constituted about 57% of all staph
infections in Bradford and Pittsburgh.